Jun Zhang,1,* Anni Yang,1,* Tengyu Chen,1,* Yufeng Cao,1 Qiliang Lv,1 Yingxiang Xu,1 Zhenpeng Liao,1 Xianzhen Chen,1 Zhongkang Ye,1 Renjie Lai,1 Haiyu Hong1,2 

1Department of Otolaryngology, Head and Neck Surgery, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province, People’s Republic of China; 2Allergy Center, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong Province, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Haiyu Hong, Department of Otolaryngology, Head and Neck Surgery, Allergy Center, The Fifth Affiliated Hospital of Sun Yat-sen University, 52 of Meihua East Road, Zhuhai, Guangdong, 519000, People’s Republic of China, Tel +8607562528832; +8613823070089, Email honghy@sysu.edu.cn

Purpose: To investigate the diagnostic potency of the opacification-development ratio (ODR) for pediatric chronic rhinosinusitis based on CT scanning.
Patients and Methods: Children aged 0– 15 years who underwent nasal CT scanning from August 2011 through July 2021 were included in the research. The area under receiver operating characteristic curve (AUC) and predictive value were used to assess the diagnostic accuracy of the ODR and Lund-Mackay score based on CT scanning.
Results: A total of 1820 patients (217 in the positive symptom group and 1603 in the negative symptom group) who underwent CT scanning were included in the study. A significant positive correlation was observed between the ODR and the Lund-Mackay score in all age groups. In children aged 0– 15 years, the AUC of the ODR and the Lund-Mackay score were 0.7970 and 0.7719, respectively (p > 0.05). The optimal cut-off value for the ODR was 25.83, with a sensitivity of 57.14% and a specificity of 94.2%. In contrast, the optimal cut-off value for the Lund-Mackay score was 6.5, with a sensitivity of 6.5% and a specificity of 85.84%. Notably, the ODR score demonstrated significantly superior performance compared to the Lund-Mackay score in children aged 0– 4 years (p < 0.001).
Conclusion: In diagnosing pediatric chronic rhinosinusitis, the use of CT scans is associated with a higher rate of false positives when compared to clinical symptoms. The ODR score based on CT scanning is a valuable diagnostic tool for chronic rhinosinusitis in children aged 0– 11, particularly those aged 0– 4.

Keywords: chronic rhinosinusitis, children, Lund-Mackay score, retrospective study, CT imaging